Dianne Nunnally Hoppes Laboratory for Diabetes Complications, Harvard Medical School, Boston, MA, USA.
Circ Res. 2010 Apr 30;106(8):1319-31. doi: 10.1161/CIRCRESAHA.110.217117.
Both cardio- and microvascular complications adversely affect the life quality of patients with diabetes and have been the leading cause of mortality and morbidity in this population. Cardiovascular pathologies of diabetes have an effect on microvenules, arteries, and myocardium. It is believed that hyperglycemia is one of the most important metabolic factors in the development of both micro- and macrovascular complications in diabetic patients. Several prominent hypotheses exist to explain the adverse effect of hyperglycemia. One of them is the chronic activation by hyperglycemia of protein kinase (PK)C, a family of enzymes that are involved in controlling the function of other proteins. PKC has been associated with vascular alterations such as increases in permeability, contractility, extracellular matrix synthesis, cell growth and apoptosis, angiogenesis, leukocyte adhesion, and cytokine activation and inhibition. These perturbations in vascular cell homeostasis caused by different PKC isoforms (PKC-alpha, -beta1/2, and PKC-delta) are linked to the development of pathologies affecting large vessel (atherosclerosis, cardiomyopathy) and small vessel (retinopathy, nephropathy and neuropathy) complications. Clinical trials using a PKC-beta isoform inhibitor have been conducted, with some positive results for diabetic nonproliferative retinopathy, nephropathy, and endothelial dysfunction. This article reviews present understanding of how PKC isoforms cause vascular dysfunctions and pathologies in diabetes.
心脑血管并发症均会降低糖尿病患者的生活质量,且是导致该人群死亡率和发病率升高的主要原因。糖尿病的心血管病变会影响微静脉、动脉和心肌。高血糖被认为是糖尿病患者发生微血管和大血管并发症的最重要代谢因素之一。目前有几种重要假说可以解释高血糖的不良影响。其中之一是高血糖慢性激活蛋白激酶 C(PKC),PKC 是一组参与控制其他蛋白质功能的酶,与血管改变有关,如通透性增加、收缩性增加、细胞外基质合成、细胞生长和凋亡、血管生成、白细胞黏附以及细胞因子激活和抑制。不同 PKC 同工型(PKC-α、β1/2 和 PKC-δ)引起的血管细胞内稳态的这些改变与大血管(动脉粥样硬化、心肌病)和小血管(视网膜病变、肾病和神经病变)并发症的发展有关。已经进行了使用 PKC-β同工型抑制剂的临床试验,对糖尿病非增殖性视网膜病变、肾病和内皮功能障碍有一些积极的结果。本文综述了目前对 PKC 同工型如何导致糖尿病血管功能障碍和病变的理解。